November 26, 2007
View Full PaperElectrocardiograms Should Be Included in Preparticipation Screening of Athletes
Key Result
Electrocardiogram screening in athletes involves specific criteria for abnormalities, such as a heart rate-corrected QT interval >0.44 s in males and >0.46 s in females.
Structured PICO
Should electrocardiograms be included in preparticipation screening of athletes?
P
Population
Athletes undergoing preparticipation screening
I
Intervention
Electrocardiogram (ECG) screening
The document provides detailed ECG criteria to identify potentially dangerous structural and electrical cardiac abnormalities during the preparticipation screening of athletes.
Abstract
P waveLeft atrial enlargement: negative portion of the P wave in lead V 1 Ն0.1 mV in depth and Ն0.04 s in duration Right atrial enlargement: peaked P wave in leads II and III or V 1 Ն0.25 mV in amplitude QRS complex Frontal plane axis deviation: right Ն120°or left Ϫ30°to Ϫ90°I ncreased voltage: amplitude of R or S wave in a standard lead Ն2 mV, S wave in lead V 1 or V 2 Ն3 mV, or R wave in lead V 5 or V 6 Ն3 mV Abnormal Q waves Ն0.04 s in duration or Ն25% of the height of the ensuing R wave or QS pattern in Ն2 leads Right or left bundle-branch block with QRS duration Ն0.12 s R or RЈ wave in lead V 1 Ն0.5 mV in amplitude and R/S ratio Ն1 ST segment, T waves, and QT interval ST-segment depression or T-wave flattening or inversion in Ն2 leads Prolongation of heart rate-corrected QT interval Ͼ0.44 s in males and Ͼ0.46 s in females Rhythm and conduction abnormalities Premature ventricular beats or more severe ventricular arrhythmias Supraventricular tachycardias, atrial flutter, or atrial fibrillation Short PR interval (Ͻ0.12 s) with or without delta wave Sinus bradycardia with resting heart rate Յ40 bpm* First-(PR Ն0.21 s †), second-, or third-degree atrioventricular block